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泰国一家大学医院医护人员职业暴露后使用艾滋病毒暴露后预防用药情况

Use of HIV Postexposure Prophylaxis in healthcare workers after occupational exposure: a Thai university hospital setting.

作者信息

Kiertiburanakul Sasisopin, Wannaying Bunchong, Tonsuttakul Sirirat, Kehachindawat Pranee, Apivanich Siriluk, Somsakul Somporn, Malathum Kumthorn

机构信息

Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2006 Jul;89(7):974-8.

Abstract

BACKGROUND

PostExposure Prophylaxis (PEP) is widely used after exposures to Human Immunodeficiency Virus (HIV) to reduce the risk of infection in the healthcare setting. Few data are available on the safety and tolerability of Anti Retro Viral drugs (ARV) among Health Care Workers (HCWs) who are prescribed prophylaxis.

OBJECTIVE

To collect information about the safety and compliance of taking ARV for HIV PEP among HCWs.

MATERIAL AND METHOD

Retrospective review on registry data regarding occupational HIV exposures, the PEP regimens used, and the adverse events associated with PEP was performed.

RESULTS

During a five year-period, 820 episodes with occupational blood or body fluid exposures were reported Nurses (27%) were the largest group at risk. The most common type of exposure was percutaneous injuries (82%). Only 125 (15%) HCWs had occupational exposures to HIV, 64 HCWs were prescribed HIV PEP and 32 (50%) HCWs did not complete the PEP regimen as initially prescribed. The commonly prescribed ARV was zidovudine (38%), lamivudine (33%), and indinavir (11%). Overall, 18 (28%) HCWs reported symptoms while on PEP such as nausea (89%), vomiting (55%), and dizziness (39%). None of the HCWs had HIV seroconversion.

CONCLUSIONS

Adverse effects from HIV PEP were very common. Clinicians prescribing HIV PEP need to discuss with HCWs about PEP efficacy and side effects. Education efforts aimed at occupational exposure prevention are still important issues.

摘要

背景

暴露后预防(PEP)在医护人员暴露于人类免疫缺陷病毒(HIV)后被广泛应用,以降低感染风险。关于接受预防治疗的医护人员中抗逆转录病毒药物(ARV)的安全性和耐受性的数据较少。

目的

收集医护人员服用抗逆转录病毒药物进行HIV暴露后预防的安全性和依从性信息。

材料与方法

对职业性HIV暴露、所采用的PEP方案以及与PEP相关的不良事件的登记数据进行回顾性分析。

结果

在五年期间,报告了820起职业性血液或体液暴露事件。护士(27%)是最大的风险群体。最常见的暴露类型是经皮损伤(82%)。只有125名(15%)医护人员发生职业性HIV暴露,64名医护人员接受了HIV暴露后预防治疗,32名(50%)医护人员未按最初规定完成PEP方案。常用的抗逆转录病毒药物是齐多夫定(38%)、拉米夫定(33%)和茚地那韦(11%)。总体而言,18名(28%)医护人员在接受暴露后预防治疗期间报告出现症状,如恶心(89%)、呕吐(55%)和头晕(39%)。没有医护人员发生HIV血清转化。

结论

HIV暴露后预防的不良反应非常常见。开具HIV暴露后预防治疗处方的临床医生需要与医护人员讨论暴露后预防的疗效和副作用。旨在预防职业暴露的教育工作仍然是重要问题。

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